Pulmonary Complications of Transfused Blood Components

Benson, Alexander B.

doi:10.1016/j.ccell.2012.06.005

Cited by 20 publications

(17 citation statements)

References 107 publications

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“…FFP was associated with an increased risk of infection in surgical patients [23]. Blood transfusion can lead to pulmonary complications, which are responsible for the majority of morbidity and mortality, associated with blood component transfusion in hospitalized patients [24]. …”

Section: Discussionmentioning

confidence: 99%

Thromboelastometry-guided hemostatic therapy for hemorrhagic shock in the postoperative period of vascular surgery: a case report

Crochemore

Savioli

2018

J Med Case Reports

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BackgroundHemorrhagic shock is a medical emergency that often complicates vascular surgery and can lead to death. Hemorrhagic shock is characterized by hypoperfusion and hemodynamic abnormalities leading to the collapse of homeostasis due to massive blood loss. Early diagnosis is critical for a favorable outcome. Thromboelastometry has been considered an effective tool for bleeding management in critically ill patients. Thromboelastometry can guide transfusion therapy quickly, reducing the need for blood products. Therefore, it could be an alternative test to guide hemostatic therapy in complex cases of hemorrhagic shock as a result of vascular surgeries. We report our successful experience with a case of hemorrhagic shock in postoperative care in vascular surgery, in which bleeding management was guided by thromboelastometry and bleeding control was achieved with hemostatic drugs and coagulation factor concentrates.Case presentationWe report a case of an 82-year-old Afro-Brazilian man who presented to the intensive care unit with hemorrhagic shock in the postoperative period of vascular surgery. He underwent surgery for correction of iliac artery aneurysm with endoleak. His laboratory tests revealed severe anemia (hemoglobin 7.4 mg/dL), metabolic acidosis (bicarbonate 10 mEq/L, pH 7.11), acute kidney injury (creatinine 3.1 mg/dL), thrombocytopenia (platelets count 83 × 103/mm3), hypofibrinogenemia (70 mg/dL), international nationalized ratio 1.95, activated partial thromboplastin time 64.5 seconds, and lactate 87 mmol/L. There was active bleeding in surgical site. Bleeding management was guided by thromboelastometry. The first test showed fulminant hyperfibrinolysis, which was corrected with the administration of tranexamic acid. The second thromboelastometry test showed improvement of hyperfibrinolysis but severe hypocoagulability. Fibrinogen concentrate, platelet apheresis, cryoprecipitate, and prothrombin complex concentrate were sequentially administrated. Thromboelastometry was completely corrected after 2 hours. Arteriography to evaluate mechanical cause of bleeding was normal. No more bleeding was identified, and neither was any further transfusion needed. He was discharged from the intensive care unit from the ward 3 days after admission.ConclusionsThromboelastometry may be considered a useful, feasible and safe tool to monitor and manage coagulopathy in patients with hemorrhagic shock. Moreover, it has the potential benefit of allowing rapid diagnosis, goal-directed therapy with hemostatic drugs and coagulation factor concentrates and thus, avoiding unnecessary blood component transfusion.

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Section: Discussionmentioning

confidence: 99%

Thromboelastometry-guided hemostatic therapy for hemorrhagic shock in the postoperative period of vascular surgery: a case report

Crochemore

Savioli

2018

J Med Case Reports

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“…A useful distinction of transfusion-related immunomodulation's pulmonary complications from transfusion-related acute lung injury is the delayed onset and often infectious (pneumonia) etiology. 153 bacterial Contamination…”

Section: Transfusion-related Immunomodulationmentioning

confidence: 99%

Transfusion-related Acute Lung Injury in the Perioperative Patient

et al. 2019

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“…2) неиммунное повреждение, которое развивается как ответ организма на биологически активные липиды в консервированной крови. Этот тип повреждения имеет более доброкачественное течение и может потребовать лишь кислородной терапии [45,46].…”

Section: особенности действия лекарственных препаратов во время общейunclassified

Risks assessment of respiratory failure in patients before surgery

Малявин¹,

Malyavin²,

Бабак³

et al. 2017

Endosk. khir.

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На сегодняшний день имеющиеся в литературе данные посвящены оценке и стратификации рисков развития послеоперационных дыхательных осложнений (ПДО) у пациентов, нуждающихся в различных видах хирургического вмешательства. До настоящего времени не разработано единого алгоритма стратификации рисков развития ПДО. Предоперационная оценка функции легких и кардиореспираторной системы в целом играет важную роль в стратификации рисков у больных, нуждающихся как в плановой, так и в экстренной хирургической помощи. В настоящее время показатели частоты развития ПДО в раннем послеоперационном периоде составляет 15-46%, что увеличивает пребывание больного в стационаре и послеоперационную летальность. Выявление пациентов с прогностически высоким риском развития ПДО приобретает важное значение в предоперационной подготовке больных. Ключевые слова: дыхательная недостаточность, торакальная хирургия, абдоминальная хирургия, послеоперационные дыхательные осложнения.

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Pulmonary Complications of Transfused Blood Components

Cited by 20 publications

References 107 publications

Thromboelastometry-guided hemostatic therapy for hemorrhagic shock in the postoperative period of vascular surgery: a case report

Thromboelastometry-guided hemostatic therapy for hemorrhagic shock in the postoperative period of vascular surgery: a case report

Transfusion-related Acute Lung Injury in the Perioperative Patient

Risks assessment of respiratory failure in patients before surgery

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